Provider Demographics
NPI:1639310303
Name:VICTORIA PAPPAS-VILLAFANE, APN, LLC
Entity Type:Organization
Organization Name:VICTORIA PAPPAS-VILLAFANE, APN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPPAS-VILLAFANE
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:732-455-3870
Mailing Address - Street 1:3301 ROUTE 66
Mailing Address - Street 2:BUILDING B, SUITE 106
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-2705
Mailing Address - Country:US
Mailing Address - Phone:732-455-3870
Mailing Address - Fax:732-455-3872
Practice Address - Street 1:3301 ROUTE 66
Practice Address - Street 2:BUILDING B, SUITE 106
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-2705
Practice Address - Country:US
Practice Address - Phone:732-455-3870
Practice Address - Fax:732-455-3872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC05307100363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP18253Medicare UPIN